Floodplain Protection Project Reviews: FEMA Community Acknowledgement / PA DEP Request Form

Floodplain Protection Project Reviews: FEMA Community Acknowledgement / PA DEP Request Form

Please use this form to request Community Acknowledgement / Consistency Signoff from the Department of Licenses and Inspections for State or Federal approvals associated with Floodplain Protection Projects.
Applicants Name*

First NameLast Name
Applicants Email*
example@example.com
Applicants Phone Number*
Project Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preliminary Project Review Application Number:*
(i.e. PA-xxxx-xxxxxx)
Floodplain Protection Project Community Acknowledgement / Consistency request is associated with:*

PA DEP Chapter 105/106 Permit Consistency LetterFEMA MT-1/MT-2 Community Acknowledgment Form Signoff
Is the Preliminary Project Review application in the "Submitted" status and application fees paid?*

YesNo
Note: You must submit your Preliminary Project Review application and pay the fee before completing this JotForm.
Should be Empty: